Impact of immune checkpoint inhibitors combined with thoracic radiotherapy on the survival of patients with synchronous oligometastatic non-small cell lung cancer
10.3760/cma.j.cn112271-20250303-00070
- VernacularTitle:免疫检查点抑制剂联合胸部放疗对同时性寡转移非小细胞肺癌患者生存的影响
- Author:
Zhe DU
1
;
Yuting ZHAO
1
;
Anhui SHI
1
;
Huiming YU
1
;
Rong YU
1
;
Weihu WANG
1
Author Information
1. 北京大学肿瘤医院暨北京市肿瘤防治研究所放疗科 恶性肿瘤发病机制及转化研究教育部重点实验室，北京 100142
- Publication Type:Journal Article
- Keywords:
Non-small cell lung cancer (NSCLC);
Synchronous oligometastasis;
Immune checkpoint inhibitor (ICI);
Thoracic radiotherapy;
Survival outcome
- From:
Chinese Journal of Radiological Medicine and Protection
2025;45(7):637-646
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the prognostic value and safety of thoracic radiotherapy in patients with synchronous oligometastatic, driver gene-negative non-small cell lung cancer (NSCLC) receiving immune checkpoint inhibitors (ICIs) as first-line treatment.Methods:Data were retrospectively collected from 55 patients diagnosed with synchronous oligometastatic, driver gene-negative NSCLC who received first-line ICIs from January 2017 to March 2022. These patients were categorized into two groups based on the administration of thoracic radiotherapy: the thoracic radiotherapy group ( n = 27) and the non-thoracic radiotherapy group ( n = 28). Comparative analyses were conducted to evaluate survival outcomes and safety profiles between the two groups. Results:Among the 55 patients, 27 (49.1%) received thoracic radiotherapy. The median follow-up time was 37.0 months (2.2-76.7 months). Patients in the thoracic radiotherapy group exhibited significantly improved median overall survival (OS: 53.4 vs. 21.3 months, P = 0.049) and median progression-free survival (PFS: 13.6 vs. 8.3 months, χ2=4.11, P = 0.043) compared to those in the non-thoracic radiotherapy group. Multivariate Cox regression analysis identified thoracic radiotherapy as an independent prognostic factor for OS ( HR = 0.39, 95% CI: 0.17-0.90, P = 0.027) and PFS ( HR = 0.53, 95% CI: 0.28-0.99, P = 0.046). The most common grade 3 or higher toxicity was bone marrow suppression, occurring in seven patients (12.7%). There was no significant difference between both groups in the incidence of grade 3 or higher treatment-related adverse events, including pneumonitis. Conclusion:In patients with driver gene-negative, synchronous oligometastatic NSCLC, first-line immunotherapy combined with thoracic radiotherapy may improve survival outcomes without increasing the incidence of severe treatment-related adverse events. Further large-scale, randomized prospective trials are needed to verify the findings of this study.
